Chinese Eschew Aids Drugs

November 11, 2003|By Philip P. Pan The Washington Post

BEIJING — One in five AIDS patients receiving free antiretroviral drugs from the Chinese government abandoned the "drug cocktail" in the first seven months of the program, raising the risk that drug-resistant strains of the AIDS virus might emerge and spread across China and then the world, Chinese officials and researchers acknowledged Monday.

The disclosure, made during an international AIDS conference at Qinghua University, highlights the enormous challenge that AIDS presents the Chinese government. It has taken tentative steps to confront the epidemic after years of denial but is having trouble getting its underfunded, sometimes corrupt health care system to respond effectively. The United Nations estimates that the AIDS virus has infected as many as 1.5 million people in China.

The government began offering free antiretroviral drugs in April to patients in certain poor areas hit hard by AIDS. A senior Health Ministry official announced in a Sept. 24 speech at the United Nations that the government was committed to providing free medicine to all AIDS patients with "economic difficulties."

But if the government continues distributing drugs without putting in place a network of trained counselors and medical personnel to administer them, patients could continue dropping out of treatment and drug-resistant strains of HIV could emerge and exacerbate the crisis, several researchers said.

The program suffers from a variety of other problems, too. Some residents report that local officials are charging them for the drugs, while others complain that doctors are unavailable or are afraid to accept them as patients.

Zhang Fujie, director of treatment for China's national AIDS control center, said more than 1,040 of the 5,289 patients receiving free drugs have discontinued treatment. He said still others may have stopped taking the drugs without notifying the government or may be taking the drugs only occasionally, which also increases the risk of drug-resistant HIV strains developing.

Zhang attributed the high dropout rate to the severe side effects caused by the drugs. He blamed this problem on both the limited mix of low-cost drugs available in China and a shortage of qualified medical staffs who can monitor patients and fine-tune treatment to manage side effects. He also said China lacked the necessary lab equipment to help doctors measure the effect of the drugs.

Zhang said fewer than 100 doctors in China have experience treating AIDS. Shao Yiming, a leading government virologist, said one problem China faces is the limited selection of antiretroviral drugs available at low cost. Despite the difficulties and the risk of drug-resistant HIV strains developing, Zhang said the government was pressing ahead with plans to distribute more drugs

David Ho, the American researcher credited with developing the "drug cocktail" treatment for AIDS and a keynote speaker at the conference, said the high dropout rate was troubling. But he urged the government to continue offering the free drugs and to work harder to train doctors, nurses and counselors.